Individual provider Active NPI

Sandra K Elliott, PT

  • Physical Therapist
  • North Bend, WA
National Provider Identifier
1619922804
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00005045 Issued in WA
Practice address
44727 SE 161St PL
North Bend, WA 98045-8703
Phone
(425) 292-0227
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00005045 WA Primary

Addresses

Primary practice location

44727 SE 161St PL
North Bend, WA 98045-8703

Mailing address

44727 SE 161St PL
North Bend, WA 98045-8703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00005045WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 4, King County Wa Physical Therapist Past Accepting new patients
Olympic Physical Therapy, Inc. Physical Therapist Past Accepting new patients
Olympic Physical Therapy of Bellevue Inc. Physical Therapist Past Accepting new patients
Olympic Physical Therapy, Inc Physical Therapist Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1619922804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44727 SE 161ST PL",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "980458703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44727 SE 161ST PL",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "980458703",
            "telephone_number": "425-292-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "SANDRA",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00005045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bend, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.